Total Knee Replacement

Rehabilitation Programme

It is generally accepted that uni-compartmental and knee replacements should be kept under surveillance so that potential problems are identified at an early stage.
The knee review programme has been established to monitor the performance of your artificial knee.
The Review programme consists of three elements:

X-Ray examinations to check on the condition of your artificial knee and the bone and cartilage around it

Below is a summary of when each review should take place

X- ray and clinical assessment 1 year after surgery

X- ray every five years after surgery

Two Yearly questionnaire, 3, 5, 7, 9 years after surgery...

We advise repeat clinical assessment at 5 years, 10 years and 15 years…

Possible Complications

This is a very successful operation, but there are some risks associated with any procedure. For a knee replacement they include:
Anaesthetic - Modern anaesthetics are generally very safe. The anaesthetist will explain any particular risks to you.
Infection - There is a small risk of infection of the joint following the operation but you will be given antibiotics to help prevent this. If after you get home you notice fever, increased pain, swelling and redness around the wound, please phone contact our office.
Deep vein thrombosis (a blood clot in a leg vein) - You may have anti- coagulant medication and support stockings to help prevent it. A symptom of this may be an acute pain in your calf. Please contact us urgently.
Loosening - Your new knee may become loose with time or eventually wear out and need to be replaced.
Numbness – there is typically numbness on the outer side of the knee. This relates to the small skin nerves that have to be cut during the operation. Some of this numbness, but not all, will recover. It should not stop you from kneeling if you wish to kneel.
All patients will need a full blood count on day 1 and again days 4 and 7 if still in Hospital for thrombocytopenia although the incidents of HIT with low dose prophylaxis seems to be much lower than initially feared.

General home advice

You can expect some pain but not the same sort of pain as you had before the operation. The time it lasts will vary from a few days, to several weeks; everyone is different. It is important to take your painkillers as advised.
Swelling and bruising may take up to 6-8 weeks to disappear; for some it can last up to 6 months.
The dissolving stitches and paper strips (steri- strips) closing your wound, can normally be peeled off 14 days after the operation.
One of Professor Haddad’s nurses will keep in touch with you by phone and a follow-up appointment 6 weeks after surgery will have been booked prior to your operation.
After your stitches and steri-strips have been removed you can have a shower or bath once we have shown you how to use it safely. Until then your wound will need to stay covered with a waterproof dressing.
When in bed, take care not to remain in one position for too long to prevent your heels, ankles or back getting sore; change your position every one to two hours.
Try to gradually increase your activity each day by walking as well as continuing your exercises.
You must not drive or resume any sporting or gardening activities until you have seen Professor Haddad and he has cleared you to do so.

Physical activities after your operation

A physiotherapist will visit you pre-surgery, and on the day after your surgery and begin teaching you how to use your new knee. If necessary, you may be fitted with a continuous passive motion (CPM) machine that will slowly and smoothly straighten and bend your knee.
You will have post-operative Xrays.
You will start to put your full weight on the knee with the support of a frame and then crutches even on the day of surgery,
Most patients just need a stick by the time they are ready to go home 3-5 days later.

Pain Relief

Good pain relief is important and some people need more pain relief than others.

Pain relief can be increased, given more often, or given in different combinations.

Please ask help from the nurses on the ward if you are in any discomfort.